Endoscopic drainage of peripancreatic fluid collection through gastric wall:a report of 5 children with a literature review
Objective To explore the clinical efficacy of endoscopic drainage of peripancreatic fluid collection(PFC)through gastric wall in children.Methods From March 2019 to March 2022,the relevant clinical data were retrospectively reviewed for 5 children undergoing endoscopic transgastric peripancreatic fluid drainage.Clinical profiles,treatments and outcomes were recorded.And the related literatures were retrieved from the databases of CNKI,Wanfang,PubMed and Embase until June 1st,2022.Results There were 1 boy and 4 girls with a median age of 8 years.There were lymphoma after asparaginase chemotherapy(n=2),trauma(n=2),and complications of pancreatic tumor resection(n=1).Median diameter of cyst was 9.1(6.8-9.8)cm on computed tomography(CT).There were nasocystal drainage(n=2),bile duct stent drainage(n=2)and ERCP pancreatic duct papillary drainage(n=1).Moreover,1 child was re-operated due to a recurrence of pancreatic cyst.Postoperative follow-up CT was performed.Position of drainage catheter was normal.Five cases of cysts decreased or disappeared to varying degrees after operation.And 4 children had a marked relief without obvious surgical complications.Through literature searching,14 articles of endoscopic treatment of peripancreatic effusion were retrieved,including 65 children with peripancreatic effusion undergoing endoscopic incision and drainage through gastric or duodenal wall.Success rate of operation was 93.8％(61/65)and rate of reoperation due to complications 12.3％(8/65).A major cause for reoperation was stent blockage(5/8).Conclusions External drainage of PFC through gastric wall under gastroscopy or duodenoscopy is both safe and effective.Some cases require a variety of drainage modes.
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